A Comparative Study of the Amount of Smoke Absorbed From Low Yield (‘Less Hazardous’) Cigarettes.

Abstract

Twenty-two smokers (^20 cigarettes per day with an average nominal nicotine delivery of .96 mg) were split randomly into treatment (16 subjects) and control (6 subjects) groups. During the first two-week period (Pi), all subjects smoked their usual brand. For the next three weeks (P2) the treatment group switched to a cigarette averaging .64 mg, while the control group switched to another brand within ± .1 mg of their usual brand. During the last three weeks (P^) the treatment group switched to a still lower vented cigarette (.38 mg nicotine) while the control group switched to another brand again having a nominal delivery within ± .1 mg of their usual brand.Both treatment and control groups were dissatisfied with their substitute brands suggesting that the dissatisfaction may be to the act of switching cigarettes rather than to any decrease in cigarette yield.The non-invasive exposure measures employed (average number of cigarettes per day, daily mouth level nicotine intake, butt length, expired air carbon monoxide and saliva thiocyanate) demonstrated that the almost complete compensation of the treatment group was achieved with a combination of increased cigarette consumption, smoking intensity and depth of inhalation.Thus, the assumed health advantage for relatively heavy smokers switching to lower delivery cigarettes is largely offset by the tendency of smokers to compensate.

Smoking behaviour and compensation: A review of the literature with meta-analysis

“…(ii) Studies which investigated the impact of a significant reduction in the nicotine content on smoking behaviour, termed here as 'RNC studies'. In Supplementary data No 2, Table D, data from 19 non-RNC studies 5 are listed (Armitage et al, 1988;Benowitz et al, 1982Benowitz et al, , 1986Benowitz et al, , 2005Benowitz et al, , 2009Fagerström, 1982;Feng et al, 2006;Frost et al, 1995;Guyatt et al, 1989;Haley et al, 1985;Hammond et al, 2005;Kolonen et al, 1988;McAdam et al, 2011;Robinson et al, 1982Robinson et al, , 1983Roethig et al, 2005Roethig et al, , 2007Russell et al, 1982;Shepperd et al, 2011;Zacny and Stitzer, 1988), for which CIs were calculated by applying formulae (2e) and (5). In addition, Table D lists four RNC studies (Benowitz et al, , 2007(Benowitz et al, , 2012Hatsukami et al, 2010), for which nicotine biomarker-based CIs were calculated using formula (2e).…”

Clinical Trials Methods for Evaluation of Potential Reduced Exposure Products

“…These studies used either a between-subject design comparing different products (56, 61, 70–78), within-subject design taking assessments during usual brand cigarette smoking and after switching to a product (79–81) or within-subject cross-over design with different products (23, 82–85). Subjects were required to use a specific product (61, 70, 72–83, 85–89), or were given a choice after sampling the products (56, 71). Some of these studies included additional or different experimental design features.…”

“…One study allowed a 2 week acclimatization time with higher nicotine yield cigarettes compared to usual brand cigarettes and then made biomarker assessment after another two weeks of use. The values for thiocyanate and carbon monoxide were higher after the two week acclimatization period, indicating a period of time to stabilize to product use may be warranted for some products (70). …”

“…Published intermediate-term studies have control arms such as medicinal nicotine (23, 56, 72, 82–83), nonsmokers (86), smokers using their usual brand of cigarettes (79–81, 87) or a control group with conventional cigarettes similar to usual brand (61, 70, 74–76, 78, 84, 89). Some of these studies examined the effects of cigarettes with different nicotine or tar yields (70–71, 73, 76–78, 84–85, 87–89) or different amounts of product use (83).…”

Do Reductions in the Tar and Nicotine Yields of Cigarettes Help to Explain Recent Reductions in Lung Cancer Rates in Young Men and Women in the United States?

“…However, the level of compensation which fits the data best varies by age. Evidence from experimental studies in which smokers switch brands (Fagerström, 1982;Robinson et al, 1982Robinson et al, , 1983Russell et al, 1982;Benowitz et al, 1982Benowitz et al, , 1986Benowitz et al, , 2005Haley et al, 1985;Armitage et al, 1988;Kolonen et al, 1988;Zacny & Stitzer, 1988;Frost et al, 1995;Hecht et al, 2005;Hammond et al, 2005) and in cross-sectional studies comparing smokers of brands with different tar and nicotine yields (Russell et al, 1980(Russell et al, , 1986Heller et al, 1982;Ebert et al, 1983;Hill et al, 1983;Gori & Lynch, 1985;Bridges et al, 1986Bridges et al, , 1990aBridges et al, , 1990bSepkovic et al, 1990;Höfer et al, 1991;Woodward & Tunstall-Pedoe, 1992, 1993Rosa et al, 1992;Hee et al, 1995;Byrd et al, 1995Byrd et al, , 1998Andersson et al, 1997;Jarvis et al, 2001;Ueda et al, 2002) is consistent in demonstrating some reduction in nicotine intake following a reduction in yield. Though estimates from some studies (e.g.…”